Analyzing access to modern contraception and understanding reproductive rights among women with intellectual and developmental disabilities in North Carolina: A mixed methods study

The reproductive health needs of persons with intellectual and developmental disabilities (IDDs) have been historically overlooked. Despite having an equal or greater chance of pregnancy, women with IDDs face significant barriers to accessing contraception. Publicly available survey data exclude individuals who live in institutional settings or require communication assistance, and little is known about the landscape of sexual and reproductive health services within residential facilities. To address these gaps, this Bass Connections Student Research Award project aims to analyze differences in access to and use of contraceptive services among women of reproductive age in North Carolina, as well as understand offerings, needs, facilitators, and barriers relating to contraception within public and private residential facilities. Linear regression and clustering techniques will be applied to a robust Medicaid claims dataset to evaluate contraceptive insertion, surveillance, and removal by disability status. In addition, in-depth interviews will be conducted with administrators, clinicians, and social workers at six residential facilities in North Carolina. The final...
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Student Advisory Board Update

The Student Advisory Board aims to increase engagement with the Center by fostering academic collaboration and advocacy efforts. Now in its third year, the SAB has grown to encompass undergraduates and graduate students across Duke. Over the past few years, student work has been featured on the Center's website as well as newsletters. Students have also helped bring in multiple speakers from various backgrounds, including researchers and SRH advocacy organizations. This year, the Student Advisory Board consists of the Communications Working Group and the Events Working Group. I'm pleased to be working with Angela and Lauren as they are leading both of these groups and are planning incredible ways for students to get more involved with the Center. Hear more about the work they are doing below. From Angela Huang, the Communications Working Group Chair: The Student Advisory Board Communications Committee, made up of both undergraduate and post-graduate students, sets out to form connections between the Duke student populace with the Center for...
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Director’s Blog October 2021

Director’s Blog October 2021

In my last blog, written as we were celebrating graduation and Covid numbers were falling, I challenged readers to think about lessons from the pandemic and plan for a new and improved post-pandemic world. In retrospect, that optimism was clearly a little premature. As the Delta variant swept through the country, it not only changed the timeline on any return to “normalcy,” it changed expectations that there would be a post-Covid world. The challenge became learning to live and thrive in a world with Covid. As classes are in full swing, and we’ve already passed the halfway mark for the semester, Duke students, staff and faculty have readily embraced the measures that allow us to teach and learn in person: masks, vaccinations and testing. Midterms are over, basketball is coming back to Cameron in a way that keeps everyone safe and crazy, and we are seeing more in person events that bring people together. One event that brought together large numbers...
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Note from Lauren Mitchell, Director of the Working Group for Sexual and Reproductive Health

During the Spring 2021 semester, the Working Group for Sexual and Reproductive Health grew its community of over 115 students, researchers, and advocates working across the SRH field through programming events, the Mentorship Program, and email newsletters. After being founded in the fall of 2019 by Saumya Sao, a Duke 2020 graduate, its goals of building a collaborative community, fostering relationships, and eliminating barriers to entry into SRH research for students were temporarily put on hold due to COVID-19. However, on March 19, the Working Group hosted 13 speakers at a virtual SRH Research Symposium, highlighting the work being done in the Triangle area and connecting students to potential opportunities for engagement. Speakers presented their current research across four themed areas—Digital Health and Data Science, Mental Health, Family Planning, and Innovations in HIV Care—and shared insight on how students can engage with the SRH field, both at Duke and beyond. Additionally, the SRH Advocacy Panel event on April 16 featured...
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Reflection on Contraceptive Product Development and Introduction Panel

During one of Duke’s wellness days, Kate Rademacher and Rebecca Callahan from FHI 360 presented the work being done at FHI 360 related to contraceptive development and accessibility/ acceptability in low- to middle- income countries (LMIC). As a part of FHI 360’s Contraceptive Technology Innovation Team and a public health scientist, Rebecca Callahan researches new contraceptive methods and product availability; As a technical director for the LEAP Initiative for FHI 360, Kate Rademacher supports the development of long-active contraceptives for low resources settings. At the start of the panel, Dr. Callahan introduced the research being done in FHI 360, exploring different forms of existing contraceptives and how they differ in use world-wide. Notably, she focuses on contraceptive usage in LMIC and discusses how for contraceptives to be properly received by these populations, they must have qualities like “safe and effective”, “discreet”, “low cost”, etc. Because contraceptive development is not as profitable for larger pharmaceutical companies, FHI 360 engages research for the...
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Student Spotlight: Ema Kuczura and Sarah Hubner

Student Spotlight: Ema Kuczura and Sarah Hubner

As we just finished the end of the spring semester, we wanted to highlight the work of two of our talented students: Ema Kuczura and Sarah Hubner. Q: Tell us a little bit about yourself.  Ema: I am originally from Chicago, IL. I recently graduated Duke where I majored in Public Policy and Global Health. I am a member of the Duke Women's Rowing team where I am finishing up my last season. While at Duke, I also participated in the Rubenstein-Bing Athlete Civic Engagement program, served as Co-President of the One Love student club, and served on the executive board of Duke SHAPE (Sexual Harassment and Assault Prevention and Education). Sarah: I am originally from Long Island, New York. I studied Political Science with a concentration in Security Peace, and Conflict and Global Health, and pursued a Markets and Management Studies Certificate. I have long been interested in the intersection of US foreign policy and economic development on health outcomes among marginalized populations...
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Economic Sanctions and Maternal Mortality

Economic Sanctions and Maternal Mortality

As this academic year comes to a close, so does my two-year tenure as the Duke Global Health Institute Doctoral Scholar working with the Center for Global Reproductive Health. I have been so fortunate to be mentored by Dr. Huchko and the staff both here in Durham and in Kisumu. A true highlight has been collaborating with community partners as well as undergrads and grad students here at Duke. Pei-Yu Wei, another PhD student and I started a project investigating the impact of economic sanctions on women’s rights and maternal mortality, which we recently had the opportunity to present at a national conference and two academic workshops. Economic sanctions are policy instruments used to influence the behavior of another international actor. While generally a less harmful method for countries to settle disputes compared to military force, sanctions still have the ability to adversely affect the civilian population in the targeted state. Much research has been done on the negative consequences of...
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Director’s Blog May 2021

Director’s Blog May 2021

Amid the familiar bursts of color and warm breezes that call us back outdoors for another glorious North Carolina spring, there are signs of a return to a pre-pandemic way of life. In light of increasing vaccinations and decreasing case numbers, Governor Cooper lifted the mask mandate at the beginning of May, with a plan to end most of the Covid-related restrictions in June. Duke was able to hold an in-person graduation, and is committed to having all students back on campus in the fall. So, while there is still a long road ahead of us, it’s reassuring to see some tangible plans for a return to normalcy. As we start to recover from the pandemic, this quarter’s newsletter focuses on what true healing looks like. Although everyone’s experience was unique, the pandemic undoubtedly brought some loss to all of us, whether in the form of isolation, missed opportunities, or, for too many of us, the loss of family or loved...
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Faculty Spotlight: Sara LeGrand or Liz Turner selected as part of WomenLift Health’s 2021 Global Leadership Journey cohort

Faculty Spotlight: Sara LeGrand or Liz Turner selected as part of WomenLift Health’s 2021 Global Leadership Journey cohort

Sara LeGrand Serving as an Associate Research Professor of Global Health and as the co-director of the Duke Sexual and Gender Minority Health Program, Sara LeGrand has done incredible work in exploring health care disparities worldwide through her research and her teaching. Across her 10 years at Duke, Dr. LeGrand’s research has investigated HIV prevention & disparities among sexual and gender minorities and developed digital health interventions to improve antiretroviral adherence. Her research on sexual and gender minorities also explores social determinants of health that affect mental, physical, and social health outcomes globally. Recently, Dr. LeGrand has recently been published in the International Journal of Transgender Health in the study “Mental health and challenges of transgender women: A qualitative study in Brazil and India”, exploring the lived experiences of transgender women in low - and middle - income countries with high rates of transphobia and gender-based violence.   Elizabeth Turner In her work as the Director of Duke Global Health Institute’s Research and Design...
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Cervical cancer screening and women’s empowerment in rural Kenya:  Identifying mechanisms for promoting empowerment and assessing resiliency in the wake of the COVID-19 pandemic

Cervical cancer screening and women’s empowerment in rural Kenya: Identifying mechanisms for promoting empowerment and assessing resiliency in the wake of the COVID-19 pandemic

The empowerment of women and girls in low and middle-income countries has long been recognized as a cornerstone of sustainable development. Yet despite billions in foreign aid spent on development projects annually, the international community is falling short on meeting the sustainable development goal (SDG) to achieve gender equality. The gendered impacts of the COVID-19 pandemic have provided further setbacks for women. However, incorporating mechanisms aimed at increasing women’s empowerment into existing and future development projects is one potential solution to close the gender gap. Indeed, interdependencies of the SDGs can encourage positive spillovers or downstream effects; efforts targeted at one SDG can also impact another. Following this assumption, it is possible for interventions aimed at SDG 3 (ensure healthy lives and promote well-being for all at all ages) to, for example, impact SDG 5 (achieve gender equality and empowerment of all women and girls). My dissertation project leverages these interdependencies and exploits an external health intervention targeted at women...
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